Plastic Surgery and Dermatology

The Occupational Therapy team provide inpatient and outpatient care to the Plastic Surgery and Dermatology services.

The occupational therapists are available to answer your questions and to offer support to local services that may require additional information regarding your child's needs. This is to ensure continuity in care.

Children referred to the Congenital Hand Anomalies service are born with a condition that affects the function and/or appearance of their arm or hand. We see a variety of conditions which often include radial ray dysplasia, thumb hypoplasia, arthrogryposis and symbrachydactyly. Many, but not all, of the children we see will undergo hand surgery to enhance function and appearance.

The occupational therapist aims to support the family to understand their child’s diagnosis and the impact it may have on their daily function, particularly on their hand skills. We support them through the process of hand surgery, and offer a hand therapy service, which involves assessment of pinch and grip strength, range of motion, oedema and scar management and functional skills. We frequently use splinting to protect the hand post-surgery, help maintain surgical outcomes, promote improved functional positioning and/or stretch stiff joints. Read more about how we measure treatment effectiveness from our patient and parent reported outcomes at GOSH.

We also offer assessment, advice and onward referral to local occupational therapy services for support at home and school to promote the child’s skills in independent self-care, schoolwork and play. We usually provide our service on an outpatient basis, but always in partnership with the Plastic Surgery service at GOSH.

Vascular malformations are congenital lesions composed of abnormally developed veins, sometimes associated with abnormal capillaries, arteries and lymphatics. They can cause swelling, pain and reduced movement in the affected area, which in turn impacts on the child’s function. They can occur on any part of the body, but typically occupational therapists get involved when a limb or hand is involved.

The Occupational Therapy team offers assessment and provision of compression garments, which are used as one of a number of ways of managing vascular malformations. Garments are clothes (such as gloves, sleeves or leggings) used in the long term management of these conditions and are usually worn during the day. They help facilitate return of blood flow to the heart, reduce swelling, pain and clot formation to facilitate movement and function. Appearance and comfort of the garments are important to consider.

Children with vascular malformation are seen by the Dermatology team. Some children are referred to the Plastic Surgery team if they require arm or hand surgery. The Occupational Therapy service is offered in partnership with both of these teams at GOSH.

Learn how we measure our compression garment effectiveness at GOSH.

The Occupational Therapy team provides specialist assessment and treatment to support children with Epidermolysis Bullosa.

Joint range of motion and contracture development of the hands is assessed and monitored regularly. Splints may be provided to try to delay the development of contractures and advice is given where hand surgery is indicated. Additionally, the occupational therapist may provide advice on daily functioning and hand skills and will support your local services with regards to specialist equipment and home adaptations as necessary.